Provider Demographics
NPI:1629045398
Name:CROWLEY, HOLLY M (MD)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:M
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 1378
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31799-1378
Mailing Address - Country:US
Mailing Address - Phone:229-226-7544
Mailing Address - Fax:229-226-0314
Practice Address - Street 1:509 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6645
Practice Address - Country:US
Practice Address - Phone:229-226-7544
Practice Address - Fax:229-226-0314
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA514522084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA899598871AMedicaid
GA899598871AMedicaid
GAG89555Medicare UPIN